Healthcare Provider Details

I. General information

NPI: 1801001722
Provider Name (Legal Business Name): PAULA JILL CHAMBERS P.A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2007
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

IV. Provider business mailing address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

V. Phone/Fax

Practice location:
  • Phone: 269-337-6230
  • Fax: 269-337-6530
Mailing address:
  • Phone: 269-337-6019
  • Fax: 269-337-4469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601004704
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: